| NPI | 1346745668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME175182) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A185477) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2025-08-13 |